Health Tips

Dr. Nihar Mehta

Women and Men are different only by a single chromosome - 46XX for women and 46XY for men. This single chromosome influences the physiological, physiological, behavioural characteristics of both genders. There are differences in the occurrence, presentation, course and treatment of several cardiovascular diseases between the genders. This single change sometimes protects women and at other times enhances the susceptibility of women to heart disease.

STARTLING STATISTICS! ARE WOMEN REALLY AWARE?

Majority of women are afraid of Breast Cancer! You hear several female celebrities propagating the early diagnosis of breast cancer. Some even get preventive surgery for it! However, you rarely hear of an actress promoting prevention of heart attacks in women…

The fact is that the leading cause of death in women is Cardiovascular Disease (CVD). One third of all deaths in women are due to cardiovascular diseases.

Among heart diseases, Coronary Artery disease (including Angina and Heart Attacks) accounts for half the deaths. In other words, one in every six women dies due to coronary artery disease.

There are several Myths that women have about CVD and their own risk to develop it. It’s about time women face the reality…

Perception 1: Breast cancer is the real threat to women; not heart disease

Reality 1: 1 in 3 women die of heart disease; 1 in 30 women die of breast cancer per year

Perception 2: Heart disease affect men and old people; not young women

Reality 7: Even a healthy woman can be prone to heart disease if she has a family history of heart disease.

WOMEN AND CORONARY ARTERY DISEASE RISK FACTORS:

Non Modifiable Risk Factors:

Age

Gender

Family History

Ethnicity

Modifiable Risk Factors:

Smoking

Obesity

Lack of Physical Activity

Diet (Lacking in Fruits and Vegetables)

Hypertension

Diabetes Mellitus

Hyperlipidemia

Psychosocial Factors

The major difference in men and women is the earlier presentation of coronary artery disease in men by 8-10 years. However, women catch up post-menopause. This premenopausal protection is afforded by estrogen in women. Nevertheless, hormonal replacement therapy with estrogen post-menopause does not prevent cardiovascular disease.

UNFORTUNATE DIFFERENCES IN PRESENTATION AND TREATMENT OF WOMEN WITH CORONARY ARTERY DISEASE

Typical Symptoms commonly associated with Myocardial infarction or a heart attack in both sexes include chest pain, discomfort, pressure, or squeezing; pain radiating to the neck, shoulder, back, arms, or jaw.

Women may experience Milder Symptoms and often describe them differently

Women may more frequently experience Nonspecific Prodromal Symptoms, such as fatigue.

Dyspnea, nausea and vomiting, indigestion, fatigue, sweating, and arm or shoulder pain as presenting symptoms in the absence of chest pain were all more frequent among women than among men

Women usually have a Delayed Presentation to the hospital compared to men

Women are more likely to be misdiagnosed than men

Usually women tend to be older and with more co-morbidities like hypertension, diabetes, dyslipidemia and heart failure.

The treatment of heart attacks is not gender specific. The guidelines do not offer different treatment based on sex.

Women are less likely to receive standard treatment like aspirin, cholesterol reducing medications (statins) due to confusion in the diagnosis.

Women less frequently undergo Coronary angiography or angioplasty or bypass surgery compared to men

All these factors lead to a higher cardiovascular mortality in women less than 65 years of age, as compared to men with heart attacks.

CONCLUSION:

Heart diseases claim more lives of women than any other disease including cancer. Indian women have several misconceptions regarding heart diseases, including a false sense of immunity to heart attacks. It is important that women are made aware of the fact that they can develop heart diseases including heart attacks at any age. Women are exposed to several risk factors like high blood pressure, diabetes, high cholesterol, obesity, lack of exercise, smoking, stress, etc. in the same, if not higher frequency that men. There are several variations in the symptoms that women experience. Often women have delayed presentations, are misdiagnosed and treated sub-optimally. It is essential that women and health care providers are educated regarding these differences.